Manitoba lags behind other provinces in organ donations

Manitoba lags behind other provinces in organ donations

Manitobans donate fewer organs than almost every other province, despite having the second-most potential donors, a new study has found.

A report released Thursday by the Canadian Institute for Health Information shows that this province has around 108 potential organ donors per million people, but only 10 per cent of those who would be medically cleared to donate actually do. In Quebec, by comparison, 21 per cent of potential candidates result in donations.

ORGAN DONATION FACTS

  • Kidneys are the most common transplant needed. There are roughly 200 people awaiting kidney transplants in Manitoba, and 20 waiting for heart, lung or liver transplants.
  • There are 10,812 Manitobans registered as organ donors, but only around 10 per cent of those will actually donate their organs.
  • An average organ donor provides between three and four organs, but the healthiest donors can save or drastically improve up to eight lives if all their available organs are used.
  • If the organ donation system is improved as the report recommends, it could result in up to 4,600 more life-saving organs.
  • In Canada, nearly half of all potential donations are lost because the potential donors did not have access to a ventilator or life-support system.

Source: Transplant Manitoba and Canadian Institute for Health Information

The discrepancy is largely due to the fact that unlike in some other provinces, Manitoba only allows donations from people who are declared brain dead but still alive on life support, the report says.

“It has to do with how death is defined legally. You have to be brain dead. There’s quite an involved test to make sure because we don’t want to make an error about this,” explained Dr. Faisal Siddiqui, a physician with Transplant Manitoba’s Gift of Life program.

“It sounds silly, but there was a legal issue for a period of time where we weren’t sure if we could legally take donations from someone who hasn’t been declared brain dead,” Dr. Siddiqui said.

For example, a patient could be on life support and unresponsive. Doctors know that they will never recover and the family decides to take them off of life support. But if they don’t fit the exact requirements to be declared brain dead before their heart stops, their organs can’t be used, even if the patient has registered as an organ donor online.

That isn’t the case in British Columbia, Alberta, Quebec, or Nova Scotia. In Ontario, donations from people who suffer non-heart-beating deaths account for almost a quarter of all donations.

Transplant Manitoba wants to add this province to that list. Dr. Siddiqui said they’ve been working with the Manitoba government for the past five years to put a protocol in place that would allow for people who suffer cardiovascular deaths to be included in the donor pool.

“The most important thing to us is that if you want to give that gift, we want to make sure that happens,” Dr. Siddiqui said.

The study estimated the number of potential donors by looking at all patients who died in Canadian hospitals, who were mechanically ventilated and who had a recorded stay in an intensive care unit. They then further limited the potential donor pool by looking at criteria for excluding donors due to medical issues and type of death.

But the brain death restriction isn’t the only stumbling block keeping Manitoba’s donation numbers low. Across the country, 23 per cent of Canadian organ donors were older than 60. In Manitoba, that number falls to just nine per cent. That’s significantly lower than leading countries like the U.K. or Spain, where older donors make up nearly half of all donations.

“While older donors aren’t appropriate for all organ donations, they’re generally suitable for kidney donations, which make up about three quarters of people on the wait list,” said Kathleen Morris, CIHI’s Director of Health System Analysis and Emerging Issues.

In Canada, organ donors are around 95 per cent Caucasian. Manitoban donors, on the other hand, are much more diverse. Nearly a quarter of organs donated here come from aboriginal donors.

“Those numbers are likely an indicator of need,” Morris said. “In any given year, aboriginal Canadians are about three times as likely to have kidney infections needing dialysis or transplants. There’s a high need in the aboriginal community, and the high donation rate might be the community responding to that need.”

Dr. Siddiqui said the most important thing for Manitobans who want donate their organs is to have that conversation with their families well in advance. Even if a patient has registered as a donor, doctors still need the family’s consent after they die.

“This could be you,” Siddiqui said.

“You’re six times more likely to need an organ than to reach the criteria to be a donor. But the number of people who would be willing to give one is fewer than those who would need one. And even fewer people have actually gone out and had the conversation with their families,” he said.

The CIHI study examined available data from 2008 to 2012. To register as an organ donor, click here.

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